Venous Stasis Dermatitis

Saturday, November 11, 2017

What is venous hypertension and how does it cause venous stasis dermatitis?

Hypertension most commonly refers to the overall pressure of the circulatory system, or what would be called high blood pressure. The term hypertension can also be used to describe elevated pressures in specific regions of the body.

Circulation is obviously derived from the word circle. Blood circulates, or moves from the heart to the toes and back up to the heart. The front side of this circle, where blood moves from the heart to the toes is called the arterial circulation. Arterial blood is well oxygenated and supplies oxygen to the tissues of the lower extremity. As the blood returns to the heart, or what we’ll call the back side or venous return, pressure can develop if the blood is not effectively carried up the legs. When pressure develops, we call this venous hypertension. Venous hypertension is typically the result of defective valves in the veins (valvular insufficiency).

Venous hypertension can result in swelling of the legs that is characteristically better in the am and worse in the pm. Swelling is called pitting edema because the swelling leaves a pit or indentation when you press a finger into it.

Venous stasis (lack of motion of the blood) is the result of venous hypertension. Venous stasis results in pressure on the skin. The changes in the skin as the result of venous stasis are called venous stasis dermatitis. Venous stasis dermatitis can be mild, showing redness of the skin along with scaling and pain. Venous stasis dermatitis can also result in deep medial ankle ulcers that require skilled wound care to resolve.

The primary treatment of venous stasis is compress therapy with compression hose. Elevation is helpful but difficult in daily practice. Serious venous wounds need to be treated with wound care and multi-layer compression wraps.

If you suspect discoloration of your ankle is due to venous stasis dermatitis, be sure to contact your podiatrist for treatment recommendations.